Good Medical Practice Research Articles

The impact of Longitudinal Integrated Foundation Training: preliminary experiences in the United Kingdom

BackgroundThe United Kingdom health system is challenged with retaining doctors entering specialty training directly after their second foundation year. Improving doctors’ training experience during the foundation programme may aid such retention. The Longitudinal Integrated Foundation Training (LIFT) pilot scheme aimed to provide a programme that improves the quality of their foundation training experience, advance patient-centred care and provide doctors with more experience in the primary care settings.MethodsDuring this pilot study, three methods were employed to evaluate and compare doctors’ experiences across their 2-year foundation training programme: Horus ePortfolio assessment of six domains for good medical practice analysed using a T-test, online survey assessments analysed using a 2-tailed chi-square test, and focus group feedback sessions with thematic analysis.ResultsDoctors completing LIFT (n = 47) scored a higher but non-significant mean score on all six domains for good medical practice versus doctors completing traditional foundation training (n = 94). By the end of foundation training, 100% of LIFT doctors rated their understanding of how primary and secondary care work together as high versus 78.7% of traditional doctors (p < 0.05). Improvements in wellbeing were observed among LIFT doctors, along with a reduction in the proportion of doctors considering leaving medical training. A significantly greater number of LIFT doctors versus traditional doctors rated their compassion for patients as high (100% versus 86.8%; p < 0.05), intended to become general practitioners (23.1% versus 13.5%; p < 0.05) and rated the extent to which they felt well informed and able to consider a general practice career rather than a hospital career as high (91.7% versus 72.3%, respectively; p < 0.05). Some LIFT doctors felt they had reduced exposure to secondary care, received less on-call experience and considered working a half-day to be problematic; challenges ameliorated by the end of the 2-year foundation programme.ConclusionThe LIFT programme enhanced the quality of foundation training and improved doctors’ experiences and competencies, generating valuable insights for the future of education and healthcare delivery. Applying the principles of LIFT to foundation training helps doctors to be more compassionate and patient-centred, leading to enhanced individualised patient care.

A Good Medical Practice of the Patients' Right to Information: An Audit Cycle of Patient Understanding and Satisfaction With Information Provided to Patients With Acute Pancreatitis.

Introduction Acute pancreatitis (AP),characterized by the inflammation of the pancreas, is a common acute surgical conditionaccounting for approximately 3% of all surgical admissions with abdominal pain and has an incidence of approximately 56 cases per 100,000 population every year. The General Medical Council (GMC), National Institute for Health and Care Excellence (NICE), andRoyal College of Nursing best practice guidelines recommend that such patients and their family membersshould be provided with both verbal and written information about acute pancreatitis and its management in a way that they can understand.The aim of this audit cycle was to find out the compliance with information provided to patients with acute pancreatitis as perthe GMC good medical practice and NICE guidelines and assess their satisfaction. Method A closed-loop audit consisting of two cycles was carried out. Thirty patients who were admitted to the department of general surgery with acute pancreatitis were provided with a questionnaire containing 11 questions asking about the information provided to them about their condition by healthcare professionals; then, interventions were carried out in the form of developing patientinformation leaflets (PILs) and encouraging healthcare professionals to distribute them and provide information to the patients and theirfamily members. Results Overall, improvements were seen in all aspects of the information being provided to patients, and particularly, more than 100% improvement was seen inpatientsatisfaction related to the information provided to them in the second cycle after the implementation of interventions. Conclusions This study concludes that patients should be given all the information they require in accordance with their right to information, in line with GMC best practice, NICE, and Royal College of Nursing best practice guidelines. A very effective way to improve the health outcomes and satisfaction of patients is to give them access to a patient information leaflet, which canallowpatients to consider their options and understand what can happen during treatment, especially when doctors have limited time to carry out detailed discussions with the patient.

FIGO best practice guidance in surgical consent.

Obtaining medical consent preoperatively is one of the key steps in preparing for surgery, and is an important step in informed decision making with the patient. According to good medical practice guidelines, doctors are required to have the knowledge and skills to treat patients as well as inform them, respect their wishes, and establish trust between themselves and their patients. Valid consent includes elements of competence, disclosure, understanding, and voluntariness. Documentation of these elements is also very important. The International Federation of Gynecology and Obstetrics (FIGO) Education Communication and Advocacy Consortium (ECAC) has realized that the quality of consent varies considerably across the world and has developed simple guidelines regarding consent and procedure-specific checklists for the most common obstetric and gynecological procedures.

High-fidelity virtual reality simulation training in enhancing competency assessment in orthopaedic training.

Surgical competence is the ability to successfully apply academic knowledge, clinical skills and professional behaviour to inpatient care. Along with ensuring patient safety, the ability to communicate effectively, collaborative teamwork and probity, and achieving satisfactory competencies form the fundamental principles of good medical practice. Current strategies to develop surgical competencies include a range of formative and summative assessments. The cancellation of traditional face-to-face meetings and training opportunities during the COVID-19 pandemic had a profound impact on the delivery of medical education and opportunities to achieve surgical competencies. Simulation learning has been used since before the pandemic to deliver surgical training across all grades and specialities, including orthopaedic surgery. Simulation-based training provides a safe, controlled environment to develop skill acquisition. Simulated surgery using virtual reality has evolved following developments in software and hardware. This article explores the role of high-fidelity virtual reality simulation to assess competencies in orthopaedic training in the post-COVID-19 era, and examines whether simulation could be used within the curriculum to augment and improve training.

Мотивация поступления врачей в общины сестер милосердия

The article «Motivation for doctors to enter the communities of sisters of mercy» discusses the possible reasons for the admission of doctors to the communities of sisters of mercy that have been operating on the territory of the Russian Empire since the middle of the 19th century. The communities were unique private charitable organizations that had as their goal the training of new female medical personnel. The reasons are identified by studying the conditions of service of doctors in the communities, which are reflected in the regulatory and office documents. This is material support, social benefits provided to doctors, awards, material for conducting medical practice and medical research. The reasons recorded in some sources of personal origin are also called. The article takes into account the historical context of the existence of doctors. Namely, the statements of representatives of the medical staff of the late XIX - early XX centuries about their financial situation, which had a negative connotation, and their assessment of the quality of training of medical personnel at the medical faculties of Russian universities. The study draws attention to the staff of doctors, their age, experience. The determined motives for entering the communities are correlated with the categories (identified by age, professional level, social status) of doctors. The result of the study is the following statements. Young doctors of the community were given the opportunity to get a job in the capital and a good medical practice. For older and more experienced doctors, the motives for getting a job in these communities were the rights of the civil service. They might also have been attracted to the idea of philanthropy from the communities of sisters of mercy and the communication and cooperation with influential representatives of high society. In addition, the research work developed in the communities attracted doctors of different ages and levels of professionalism.

551 Admissible or Overkill - Get It Right First Time (GIRFT) operative documentation for Laparoscopic Cholecystectomy

Abstract Aim Get It Right First Time (GIRFT) Laparoscopic Cholecystectomy (LC) documentation best practice was updated in September 2022. This was a combined incentive by NHS &amp; Royal College of Surgeons with the aim to improve poor operative documentation leading to medico-legal claims and preventing defence of good medical practice. We aim was to assess how we locally adhere to these. Method Retrospective 2-cycle, 2-month review of all LC (August 2022 (pre GIRFT) and September 2022 (post GIRFT)). Operation notes were scrutinised and compared to the newly set national standards. 60 operation notes were sampled (33 pre, 27 post), completed by 8 surgeons. We defined the recommendations into 24 essential and 8 non-essential elements. Results N = 0 operative notes contained 100% of the required information recommended by GIFRT. Of the pre GIRFT, 33% (n = 11) had ≥75% of the essential criteria (p = 0.162). Post GIRFT, 44% (n = 12) had ≥75% of the essential criteria (p = 0.097). Notable deviation from standards were poor documentation on patient position &amp; skin preparation (23%), intra-abdominal pressure setting (7%) and histology sent (3%). 0% stated the table position (reverse Trendelenburg or right side up). Conclusions Although the GIFRT guidelines for documentation in LC are lengthy, without them it is difficult to defend good medical practice when exposed to medico-legal claims. Despite GIFRT release, locally we only had minor improvements in documentation standards. This indicates that a set operation notes proforma and further dissemination of these recommendations may be needed to improve documentation standards.

1186 Cholecystectomy Operation Notes - a Review and Core Trainee Survey

Abstract Aim The “Good Surgical Practice” document by Royal College of Surgeons (RCS) England, in line with GMC’s “Good Medical Practice” emphasises the importance of “clear operative notes for every procedure”. The importance of clear documentation is well-established, facilitates effective handover and represents a legal document. A study was conducted to assess current documentation standards, including a survey amongst core surgical trainees on the use of a proforma for documenting cholecystectomies. Method A retrospective review of cholecystectomy operation notes collected from hospital database was performed between February 2022 and July 2022. Operative documentation was compared to the guideline published by RCS England. Specific information relevant to cholecystectomy operation were reviewed; critical view of safety/Calot’s triangle, number and type of clips, gallbladder dissection difficulty and spillage of bile/stones. Compliance to RCS standards was considered satisfactory at ≥80%. Results 109 typed operation notes were reviewed. Majority of information including date and time (100%), procedure name (99%), name of surgeon and assistant (100%), operative findings (100%) and post-operative care instructions including VTE prophylaxis (92%) were clearly documented. Shortfalls in documentation included priority of operation (63%), intraoperative complications (66%), gallbladder dissection difficulty (53%), anaesthetist name (52%), removal of ports under vision (33%) and local anaesthetic details (70%). Survey of eight core surgical trainees found a consensus that a proforma would improve understanding and documentation of the procedure. Conclusions The use of an operation note proforma in cholecystectomies could improve patient care and compliance with RCS guideline, and act as a learning modality for surgical trainees.

362 Compliance With GMC Guidelines for the Use of a Chaperone in Urology Outpatient Clinic

Abstract Aim To Identify our compliance with GMC guidelines for use of a chaperon in urology outpatient clinic. Method 1st audit included a total of 12 urologists in our team (6 consultants and 6 SpR) For each urologist, we checked records for 10 patients who attended urology OPD and had a physical examination as evidenced in the notes and/ or clinic letter N = 120 patient records checked Each urologist was given a score ( 0 = if no mention of a chaperone, 1 = if a chaperone was just mentioned or 2 = if the chaperone is identified by name or signature) Results We found propre documentation of a chaperone in only 75.25% of clinical notes and 14.6% of clinic letters. At individual level, there were poor scores for most urologists involved. Following the discussion of the 1st audit results in the urology clinical governance meeting, posters were made to raise awareness of the audit outcome as well as direct discussions with the urology team members to encourage them to improve their scores in the re audit cycle. Re audit showed significant improvement was achieved for individual as well as overall documentation in 85% of clinical notes and more than 50% of clinic letters. Conclusions As per GMC guidelines: The offer, and use, of a chaperone, including their full name and designation, should be clearly documented in patients’ notes. This can be achieved and emphasized by raising awareness of this good medical practice.

502 A Retrospective Review of Laparoscopic Colectomies Informed Consent Documentation, with a View of Standardisation Are Patients Properly Informed?

Abstract Introduction Shared decision-making and consents are fundamental to good medical practice and are paramount to our surgical practice. A lack of clear recorded information given to patients about the surgical procedure, associated risks and potential complications can cause harm. Landmark cases such as Montgomery vs Lanarkshire Health Board, emphasized the importance of accurate and informative consent forms. Aim To improve the quality of our consent forms. To standardize our consent forms for laparoscopic colectomy resection surgeries performed at The Department of General Surgery at Wye Valley NHS Trust. To produce a model consent form to reduce future medicolegal issues related to poor documentation. Method We identified 22 common risks and complications associated with any laparoscopic colectomy surgery. Consent forms were analysed for documentation of: Demographics, risk factors, clear handwriting; Known relevant risk factors associated with the procedure; Benefits and any additional procedures required and Name &amp; grade of healthcare professional. Results The most common complications mentioned across the consent forms were Anastomotic leak /Collection (94%), Wound infection, Bleeding, and DVT/PE (90%). Complications like post-op pain, post-op ileus, stoma complications, iatrogenic bladder/ureter injuries, and mortality were under-recorded. As a result, the quality of our consent forms and information provided to our patients is widely variable. Conclusions Proper completion of consent forms is crucial. Introducing a modified consent form with pre-filled risk factors/complications will allow for more accurate consent form completion ensuring relevant complications are discussed with patients.

1141 Good Medical Practice: Patient's Right to the Information - an Audit of the Patient's Understanding and Satisfaction with the Information Provided to the Patients with Acute Pancreatitis

Abstract Aim The aim of this audit was to find out if adequate information regarding acute pancreatitis as per the NICE guidelines was being provided to the patients and their family members and to assess patients’ satisfaction in terms of the provided information. Method 30 patients were admitted in the department of general surgery with acute pancreatitis were provided with a questionnaire containing 10 questions asking about the information provided to them about their condition by healthcare professionals. Results Overall, 60% of the patients were not satisfied with the information provided. None of the patients were provided written information and more than 90% were not explained condition with the help of a diagram. The other areas where the patients were not provided information were investigations done (40%), treatment (60%), provision of verbal information (26%), and alcohol as the potential cause of the condition (27%). Conclusions This audit emphasized the need of a proper explanation of acute pancreatitis to the patients and their family members. It was also found that no leaflets were available for the patients. Results were shared in the surgical team group and a leaflet has been designed and distributed to every patient with acute pancreatitis. Second Cycle After the introduction of the leaflet, improvement has been seen in almost all the areas of the information provided to the patients. Overall, satisfaction has improved from 60% to 92% in the patients admitted with acute pancreatitis.

Updating Good Medical Practice guidelines: a first step towards tackling sexism and sexual misconduct in healthcare.

Updating Good Medical Practice guidelines: a first step towards tackling sexism and sexual misconduct in healthcare.

131 Cholecystectomy operation notes - a review and core trainee survey

Abstract Aim The “Good Surgical Practice” document by Royal College of Surgeons (RCS) England, in line with GMC’s “Good Medical Practice” emphasises the importance of “clear operative notes for every procedure”. The importance of clear documentation is well-established, facilitates effective handover and represents a legal document. A study was conducted to assess current documentation standards, including a survey amongst core surgical trainees on the use of a proforma for documenting cholecystectomies. Methods A retrospective review of cholecystectomy operation notes collected from hospital database was performed between February 2022 and July 2022. Operative documentation was compared to the guideline published by RCS England. Specific information relevant to cholecystectomy operation were reviewed; critical view of safety/Calot’s triangle, number and type of clips, gallbladder dissection difficulty and spillage of bile/stones. Compliance to RCS standards was considered satisfactory at ≥80%. Results 109 typed operation notes were reviewed. Majority of information including date and time (100%), procedure name (99%), name of surgeon and assistant (100%), operative findings (100%) and post-operative care instructions including VTE prophylaxis (92%) were clearly documented. Shortfalls in documentation included priority of operation (63%), intraoperative complications (66%), gallbladder dissection difficulty (53%), anaesthetist name (52%), removal of ports under vision (33%) and local anaesthetic details (70%). Survey of eight core surgical trainees found a consensus that a proforma would improve understanding and documentation of the procedure. Conclusion The use of an operation note proforma in cholecystectomies could improve patient care and compliance with RCS guideline, and act as a learning modality for surgical trainees.

SP2.9 An Audit on Implementation of Electronic Autofilling in Consent Forms for Liver Resections in a Tertiary Center

Abstract Background As part of the GMC’s Good Medical Practice guidelines, benefits and risks should be discussed and documented accurately and in their entirety on a consent form. It is common for rarer or less significant complications or additional procedures to be missed from consent forms. Within the hepatopancreatobiliary (HPB) surgery team at Manchester Royal Infirmary, there has been a drive to evaluate the quality of the consenting process and documentation, as well as to understand the impact of the introduction of HIVE electronic patient record (EPR). Our aim is to standardize the consent forms to ensure all pertinent information are included. Methods We performed a comparison of documented risks and additional procedures against gold standard NICE guidance for liver resections performed by the HPB surgery department at Manchester Royal Infirmary. We evaluated paper consent forms from July to September 2022(n=9), electronically signed consent forms obtained from ‘HIVE’ from September to November 2022(n=29) and from December 2022 (n=19) we introduced ‘smart texts’ automated consent forms. Simple descriptive statistical analysis were used. Results Out of 20 documented risks and additional procedures, 15 were documented more frequently in consent forms following a transition to electronic patient records. Following ‘smart texts’, there was a further improvement in 14 of these risks and additional procedures. Particularly marked increase in documentation of additional procedures such as drains, lines and catheter insertion. Conclusions The introduction of HIVE and ‘smart texts’ have markedly improved the quality of the consenting process. We should be more comprehensive in educating patients about additional procedures that may be required.

Performance of ChatGPT on the Situational Judgement Test-A Professional Dilemmas-Based Examination for Doctors in the United Kingdom.

ChatGPT is a large language model that has performed well on professional examinations in the fields of medicine, law, and business. However, it is unclear how ChatGPT would perform on an examination assessing professionalism and situational judgement for doctors. We evaluated the performance of ChatGPT on the Situational Judgement Test (SJT): a national examination taken by all final-year medical students in the United Kingdom. This examination is designed to assess attributes such as communication, teamwork, patient safety, prioritization skills, professionalism, and ethics. All questions from the UK Foundation Programme Office's (UKFPO's) 2023 SJT practice examination were inputted into ChatGPT. For each question, ChatGPT's answers and rationales were recorded and assessed on the basis of the official UK Foundation Programme Office scoring template. Questions were categorized into domains of Good Medical Practice on the basis of the domains referenced in the rationales provided in the scoring sheet. Questions without clear domain links were screened by reviewers and assigned one or multiple domains. ChatGPT's overall performance, as well as its performance across the domains of Good Medical Practice, was evaluated. Overall, ChatGPT performed well, scoring 76% on the SJT but scoring full marks on only a few questions (9%), which may reflect possible flaws in ChatGPT's situational judgement or inconsistencies in the reasoning across questions (or both) in the examination itself. ChatGPT demonstrated consistent performance across the 4 outlined domains in Good Medical Practice for doctors. Further research is needed to understand the potential applications of large language models, such as ChatGPT, in medical education for standardizing questions and providing consistent rationales for examinations assessing professionalism and ethics.

Ethics in Ayurveda

Ayurveda means science of life and advises practice of those ways which are good for life and abstinence of those which are harmful.[1] Patients are always looking for quality treatment from their doctors. The basic tools of good medical practice involve professional competence, healthy relationships with patients, and good ethical practice. The regulatory agencies composed “Code of Ethics and Professional Conduct” which is updated time to time. Ayurvedic Practice Guidelines protect the rights of doctors as well as patients. The Ayurvedic Practice Guide includes information on how to practice with the restrictive regimen of standard protocol, which is essential for the physician to follow ethical behaviour because medical practice is directly related to body health. There are many ethical issues associated with medicine that are relevant to everyone. Ayurveda, the traditional science of the Indian medical system, has also prescribed a code of ethics for the practice of medicine, but has not yet been recognized therefore, it is necessary to examine the ethical behaviour of Ayurvedic practice in order to maintain the quality of the Ayurvedic profession. Ethics is the essence of all religions and philosophies as it studies or preaches the practice of those that makes conduct good, leading to happiness in life. The excessive, less or mis-indulgence of Prajna (intellect) or Indiriyartha sanyoga (contact of objects with organs of perception) is mostly due to unethical mode of life. Ayurveda sufficiently throws light on the ethical way of life so that one does not become unhappy or sick and should attain happiness.

DE02 Honing in on clinician needs: a grassroots development of an educational resource for dermatologists

Abstract Keeping up with the influx of scientific research papers can feel overwhelming, especially alongside busy clinical responsibilities. A PubMed search of the term ‘dermatology’ produced 29 565 results for 2021 alone, and, consequently, clinicians face spending hours a week scanning journals just to stay up to date. This is coupled with increasing clinical demand due to rising waiting lists and skin cancer pressures. Innovative solutions to the problem include regular newsletters, which have been proven to be an effective tool in medical education in other specialities (Kolli A, Nguyen A, Portney D et al. The Lens: can a weekly newsletter improve medical student knowledge of the ophthalmology literature? J Surg Educ 2021; 78:1905–14). To address this challenge in dermatology, we created a newsletter to make dermatology research more accessible. Two consultant dermatologists created a system whereby clinically relevant articles are chosen following a review of ∼30 journals. These are condensed into short clinical summaries, containing relevant findings, limitations and applicability, emulating a journal club style. This was initially distributed within our local hospital, but the team and readership have since expanded. From January 2022, in addition to the written newsletter, a freely available podcast for each newsletter was created giving an opportunity to learn on the move (e.g. while commuting). At 12 months, the newsletter has 206 subscribers, and the podcast has achieved 810 total plays (with download locations ranging from the USA to India). More recently, we have reached new audiences via Instagram, with 1700 views and 123 likes of the content thus far. A survey was distributed to current subscribers to determine the usefulness of the newsletter as an educational resource. Eighteen responses were received, and 100% agreed that they felt more informed on recent publications in dermatology from reading the newsletter (83% strongly agreed; 17% agreed). In addition to this, 100% felt that the articles chosen were relevant to their clinical practice (78% strongly agreed; 22% agreed). Feedback included comments such as ‘it is a great way to keep informed on recent publications that may be of interest’ and ‘super useful bite-sized information’. The General Medical Council guidance on Good Medical Practice requires doctors to ‘keep professional knowledge and skills up to date’. We feel the interest in our grassroots journal club publication and the survey results (with all our respondents feeling more informed on dermatological research, particularly with articles relevant to their clinical practice) highlight an unmet need for accessible educational resources to enable busy dermatologists to become aware rapidly and efficiently of the latest clinical developments.

Digital health competencies for the next generation of physicians.

As health care continues to change and evolve in a digital society, there is an escalating need for physicians who are skilled and enabled to deliver care using digital health technologies, while remaining able to successfully broker the triadic relationship among patients, computers and themselves. The focus needs to remain firmly on how technology can be leveraged and used to support good medical practice and quality health care, particularly around resolution of longstanding challenges in health care delivery, including equitable access in rural and remote areas, closing the gap on health outcomes and experiences for First Nations peoples and better support in aged care and those living with chronic disease and disability. We propose a set of requisite digital health competencies and recommend that the acquisition and evaluation of these competencies become embedded in physician training curricula and continuing professional development programmes.

Health service quality in 2929 facilities in six low-income and middle-income countries: a positive deviance analysis

Primary care is of insufficient quality in many low-income and middle-income countries. Some health facilities perform better than others despite operating in similar contexts, although the factors that characterise best performance are not well known. Existing best-performance analyses are concentrated in high-income countries and focus on hospitals. We used the positive deviance approach to identify the factors that differentiate best from worst primary care performance among health facilities across six low-resource health systems. This positive deviance analysis used nationally representative samples of public and private health facilities from Service Provision Assessments of the Democratic Republic of the Congo, Haiti, Malawi, Nepal, Senegal, and Tanzania. Data were collected starting June 11, 2013, in Malawi and ending Feb 28, 2020, in Senegal. We assessed facility performance through completion of the Good Medical Practice Index (GMPI) of essential clinical actions (eg, taking a thorough history, conducting an adequate physical examination) according to clinical guidelines and measured with direct observations of care. We identified hospitals and clinics in the top decile of performance (defined as best performers) and conducted a quantitative, cross-national positive deviance analysis to compare them with facilities performing below the median (defined as worst performers) and identify facility-level factors that explain the gap between best and worst performance. We identified 132 best-performing and 664 worst-performing hospitals, and 355 best-performing and 1778 worst-performing clinics based on clinical performance across countries. The mean GMPI score was 0·81 (SD 0·07) for the best-performing hospitals and 0·44 (0·09) for the worst-performing hospitals. Among clinics, mean GMPI scores were 0·75 (0·07) for the best performers and 0·34 (0·10) for the worst performers. High-quality governance, management, and community engagement were associated with best performance compared with worst performance. Private facilities out-performed government-owned hospitals and clinics. Our findings suggest that best-performing health facilities are characterised by good management and leaders who can engage staff and community members. Governments should look to best performers to identify scalable practices and conditions for success that can improve primary care quality overall and decrease quality gaps between health facilities. Bill & Melinda Gates Foundation.

Management of Medical Records at the Surgical Department of a Tertiary Hospital in Blackpool, UK: Results of an Internal Audit

Introduction: A medical record a fundamental component of a doctor’s roles and responsibilities in providing objective and evidence-based care to his/her patients. It ensures that everyone treating the patients clearly understands the patient’s needs. According to Good Medical Practice &amp; Good Surgical Practice guidelines, medical records should be taken in real time and should be accurate, legible, comprehensive, honest, non-judgmental and up-to-date. In this study we audited medical records at the surgical department of our hospital in the UK to assess the practice of medical records taking at the hospital.&#x0D; Materials and Methods: This was a follow-up audit to a baseline audit conducted in April 2021. This study was conducted from 24th January 2022 to 30th January 2022 at the surgical admission unit of Blackpool Victoria Teaching Hospital. A total of 47 sets of records corresponding to 47 emergency surgical take patients were selected and assessed in details against pre-determined assessment criteria. Data was analyzed in Microsoft excel software and summarized inform of count and percentages and presented in bar graphs.&#x0D; Results: A total of 47 sets of records were assessed for completeness based on the selected parameters. Overall, there was improvement in recording patient ID, recording of reviewing physician’s name, recording of examination findings, recording of patient management plan, and recording of final National early warning score (NEWS). Recording of reviewer name, date, and patient management plan had more than 80% improvement, while the rest were averagely recorded, ranging from 40 to 60%.&#x0D; Conclusion: The result indicated that documentation in the surgical unit was still inadequate as only three parameters; reviewer name, date and plan were being well recorded. However, there is still a lot of room for improvement and discussions are underway to implement the electronic medical records system.

Evaluation of a Pain Identification and Treatment Training for Medical Students Based on the “Good Medical Practice” Framework

Purpose: The aim of this study was to evaluate the effectiveness of a pain identification and treatment training program for medical students based on the “good medical practice” framework.&#x0D; Methods: A questionnaire was used to collect data from a total of 732 students who received the 3-day pain identification and treatment training held by the algology department between 2014 and 2021. The questionnaire included 8 questions about the definition of pain, types of pain, assessing pain, treatment methods and analgesic drugs. The students completed the questionnaire in person before training and 3 months after the training. A total of 732 pre-training and 230 post-training questionnaires were included in the analysis.&#x0D; Results: Correct response rates before and after the training, respectively, were 11.3%(n=83) and 77.4%(n=178) for knowing which nerve fibers conduct pain; 22.3%(n=163) and 74.8%(n=172) for knowing what “VAS” stands for; 76%(n=556) 90.4%(n=208) for giving correct examples of chronic pain; 6.3%(n=46) and 63.5%(n=146) for knowing what the World Health Organization’s analgesic ladder is; and 24.8%(n=178) and 87.7%(n=202) for giving correct examples of strong opioid analgesics (p